J Korean Foot Ankle Soc.  2011 Dec;15(4):217-222.

Weil Osteotomy for Freiberg's Disease

• Lee HS
• Kwon SY
• Kim DW
• Chung JW

Abstract

PURPOSE
The aim of this study was to evaluate the result of combined Weil and dorsal closing wedge osteotomy for Freiberg's disease.
MATERIALS AND METHODS
We performed combined Weil and dorsal closing wedge osteotomy of the second metatarsal under the diagnosis of Freiberg's disease in 7 patients, 7 feet (2 male and 5 female). The mean age at the time of operation was 29 years and the mean follow-up period was 31 months. Patients had no trauma history and no combined deformity of the foot. The surgical results were evaluated by VAS and weight bearing radiographs in antero-posterior and oblique projection.
RESULTS
According to Smillie staging system, there were 1 of stage II, 2 of stage III and 4 of stage IV patients. The osteotomy site was united at 8 weeks and the second metatarsal was shortened in length of average 2.8 mm. Remodeling of the metatarsal head was observed at 24 months. The mean VAS was decreased from 8.2 points preoperatively to 2.7 points at follow-up. And average range of motion of second metatarso-phalangeal joint was increased from 30o preoperatively to 45o at follow-up. There was no transfer metatarsalgia or arthritis of the metatarsal head during follow-up.
CONCLUSION
Combined Weil and dorsal closing wedge osteotomy of the metatarsal appears to be an effective procedure for the treatment of Freiberg's disease with a view to shortening of metatarsal length and elevation of metatarsal head.

Keyword

Freiberg's disease; Weil osteotomy; Dorsal closing wedge osteotomy

MeSH Terms

Arthritis
Congenital Abnormalities
Follow-Up Studies
Foot
Head
Humans
Joints
Male
Metatarsal Bones
Metatarsalgia
Metatarsus
Osteochondritis
Osteotomy
Range of Motion, Articular
Weight-Bearing
Metatarsus
Osteochondritis